Catering to a child who is a picky-eater is like being a short-order cook: chaotic. Dinnertime becomes a war zone, with hopeless battles fought over vegetables and macaroni and cheese.

Picky-eating is as normal as potty-training, a right of passage in childhood development. Taste-buds evolve and food preferences expand in these early years. Even the best of parents can have a difficult time getting their child to eat. In fact, picky-eating is one of the most common occurrences in children, often outgrown as the child reaches adolescence. But if eating behavior inhibits normal developmental and physical growth processes, it could be something much more severe – a pediatric feeding disorder.

“The difference between a fussy eater and a child with a feeding disorder is the impact the eating behavior has on a child’s physical and mental health,” says Peter Girolami, Ph.D., Assistant Director of the Pediatric Feeding Disorders Program at the Kennedy Krieger Institute in Baltimore, Maryland – one the first programs of its kind in the United States and the largest in the world to treat pediatric feeding disorders.

Obesity increases the risk of death after stroke in younger stroke patients, according to a new study.

Dr. Amytis Towfighi, of the University of Southern California, Los Angeles, and Dr. Bruce Ovbiagele of the University of California, Los Angeles used data from the National Health and Nutrition Examination Surveys (NHANES) on 20,050 adults.

Of those adults, 547 had a stroke through 2000 and had weight records available. Of these, 211 were classified as overweight, and 127 were obese.

For women, feelings of hopelessness are not just unfortunate, they are a stroke risk, U.S. researchers said on Thursday.

They said otherwise healthy women who are chronically hopeless are more likely to have a buildup of plaque in their neck arteries that can trigger a stroke.

“These findings suggest that women who experience feelings of hopelessness may have greater risk for future heart disease and stroke,” said Susan Everson-Rose of the University of Minnesota Medical School, whose study appears in the journal Stroke.

Sildenafil - marketed as Viagra—may not be much help to men who have erectile dysfunction (ED) related to post-traumatic stress disorder, a new study suggests.

Viagra is often effective for ED related to various causes—including heart disease, high blood pressure and diabetes. But studies indicate that as many of half of men who try the drug do not respond adequately.

In the new study, Iranian researchers looked at whether Viagra was helpful for combat veterans who were suffering from post-traumatic stress disorder (PTSD) as well as ED. It’s unclear how many men with PTSD suffer from sexual problems such as ED, although some studies have shown that a majority do so.

Fewer Americans are afraid that they will be unable to pay for healthcare services and fewer expect to postpone medical treatments due to costs, according to a Thomson Reuters survey published on Monday.

Researchers found a steady increase in people’s confidence about their ability to pay for healthcare services—it rose 12 percent between March and July this year.

The survey of 3,000 households showed, unsurprisingly, that people who made more money were more confident they could pay for medical care, and people who had insurance were far more confident about paying than those who lacked insurance.

Paradoxically, mortality rates during economic recessions in developed countries decline rather than increase, according to an analysis http://www.cmaj.ca/press/cmaj090553.pdf in CMAJ (Canadian Medical Association Journal) http://www.cmja.ca. In poor countries with less than $5000 GDP per capita, economic growth appears to improve health by increasing access to food, clean water and shelter as well as basic health services.

“In terms of business cycles, mortality is procyclical, meaning it goes up with economic expansions and down with contractions, and not countercyclical (the opposite), as expected,” writes Dr. Stephen Bezruchka, from the School of Public Health, University of Washington in Seattle, USA.

Studies of wealthy countries show that greater national wealth does not equate with better health for its citizens. “The United States, with the highest GNP per capita in the world, has a lower life expectancy than nearly all the other rich countries and a few poor ones, despite spending half of the world’s health care bill,” states the author. It also has the highest poverty levels of any wealthy country, with large health disparities and poor health outcomes.

Researchers at Huntsman Cancer Institute (HCI) at the University of Utah have shed new light on Ewing’s sarcoma, an often deadly bone cancer that typically afflicts children and young adults. Their research shows that patients with poor outcomes have tumors with high levels of a protein known as GSTM4, which may suppress the effects of chemotherapy. The research is published online today in the journal Oncogene.

“Doctors and researchers have long known that certain Ewing’s sarcoma patients respond to chemotherapy, but others don’t even though they have the same form of cancer,” says HCI Investigator Stephen Lessnick, M.D., Ph.D. “Our research shows that GSTM4 is found in high levels among those patients where chemotherapy doesn’t seem to work. It’s found in low levels in patients where chemotherapy is having a more positive effect.”

The research could lead to drugs that can suppress GSTM4 in certain patients. It also could lead to a screening test that could reveal which therapies will be most effective for patients. “GSTM4 doesn’t seem to suppress the benefits of all chemotherapy drugs, just certain ones. A GSTM4-based test could help to identify the best therapy for each individual patient,” Lessnick says.

Despite many medicines and other treatments for patients with vascular disease, a large international study shows these patients have a surprisingly high rate of recurring events such as strokes, heart attacks and hospitalizations as well as mortality.

Also unexpected: patients in North America (including the U.S.) experienced an above-average rate of these events. Patients in Eastern Europe had the highest rate, and those in Australia and Japan had the lowest.

The results from the international REACH (Reduction of Atherothrombosis for Continued Health) Registry, presented by a researcher from Northwestern University Feinberg School of Medicine, examined data for 32,247 patients one and three years after they enrolled in the registry. Patients who had symptomatic vascular disease had a 14.4 percent rate at one year and 28.4 percent rate at three years of having a heart attack, stroke, rehospitalization for another type of vascular event or vascular death. Patients with vascular disease in more than one location of the body had the highest event rate at 40.5 percent at three years.

Barcelona, Spain, 31 August: A new definition of syncope – most commonly perceived as an episode of fainting – makes its diagnosis more precise and now dependent on a specific cause. New 2009 ESC Guidelines for the Diagnosis and Management of Syncope define syncope as “a transient loss of consciousness due to transient global cerebral hypoperfusion characterized by rapid onset, short duration and spontaneous complete recovery”.(1)

The definition, says Professor Angel Moya from the University Hospital Vall d’Hebrón in Barcelona and Chair of the Guideline Task Force, now includes an aetiological requirement of reduced cerebral blood flow, which is new to the 2009 Guidelines. Indeed, he explains, a sudden cessation of cerebral blood flow for as short as six to eight seconds is sufficient to cause complete loss of consciousness. “Without this diagnostic addition,” he says, “the definition of syncope becomes wide enough to include other disorders such as epileptic seizures and concussion - in fact, would be nothing more than ‘loss of consciousness’, irrespective of mechanism and duration.”

The Guidelines note that syncope is also associated with a decrease in systolic blood pressure to 60 mmHg or lower, which in turn is determined by cardiac output and total vascular resistance; a fall in either can cause syncope, but a combination of both mechanisms is often present.

New 2009 Guidelines for the diagnosis and treatment of pulmonary hypertension are made public today. The Guidelines have been jointly produced by a Task Force of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS); the Task Force also included experts from the International Society of Heart and Lung Transplantation (ISHLT).

The new 2009 Guidelines provide a new clinical classification of pulmonary hypertension which identifies six different clinical groups. However, whatever the underlying causative mechanism, pulmonary hypertension is characterised by a poor prognosis. Indeed, says Professor Nazzareno Galiè, from the Institute of Cardiology at the University of Bologna, Italy, and Chairperson of the Guidelines Task Force: “It is the multidisciplinary nature of pulmonary hypertension and its severity which have made the new guidelines necessary.”

Pulmonary hypertension (the increase of blood pressure within the lung circulation) is a condition which may complicate the majority of heart and of lung diseases, or may develop without a clear initiating cause. The new 2009 Guidelines identify six different clinical groups.

Researchers led by Dr. Soheil Dadras at the Stanford University Medical Center have developed a novel methodology to extract microRNAs from cancer tissues. The related report by Ma et al, “Profiling and discovery of novel miRNAs from formalin-fixed paraffin-embedded melanoma and nodal specimens,” appears in the September 2009 issue of the Journal of Molecular Diagnostics.

Cancer tissues from patients are often stored by a method that involves formalin fixation and paraffin embedding to retain morphological definition for identification; however, this method frequently prevents further molecular analysis of the tissue because of mRNA degradation. Even so, these tissues contain high numbers of microRNAs (miRNAs), which are short enough (~22 nucleotides) to not be broken down during the fixation process.

In this study, Dr. Dadras and colleagues optimized a new protocol for extracting miRNAs from formalin-fixed paraffin-embedded tissues. Using their new procedure, they identified 17 new and 53 known miRNAs from normal skin, melanoma, and sentinel lymph nodes. These miRNAs were well-preserved in a 10-year-old specimen.

While rare, pediatric cancer is the leading cause of death by disease in children younger than 15, according to the American Cancer Society. More than 10,700 children nationwide will be diagnosed with cancer this year. However the prognosis for these youngsters is not as poor as it used to be. The five-year survival rate for children with cancer is 80 percent, which is up from 50 percent in the early 1970s. The Cancer Institute of New Jersey (CINJ) is making experts available to discuss the latest in comprehensive treatment, research, and service offerings for this unique population during the month of September, which is National Childhood Cancer Awareness Month. CINJ is a Center of Excellence of UMDNJ-Robert Wood Johnson Medical School.

Along with cutting-edge treatment, pediatric cancer patients at CINJ have access to unique services. For instance, a state-accredited classroom setting is available, providing educational support to children from pre-school through high school.

Newport Beach resident Dorys Balboa spent 11 years in pain after being involved in a car crash that injured her low back. Medication, pain management techniques and alternative therapies, such as acupuncture, offered only limited respites, but decompression surgery performed by a neurosurgeon at Cedars-Sinai Medical Center brought immediate, complete relief.

“I came out of the recovery room and I remember I could move my feet again, and I couldn’t do that for a long time. My right toe had been numb and I’d had excruciating pain all the way up my leg. I couldn’t flex my foot forward and backward,” said Balboa, 41.

“When I got out of surgery, I was moving my foot and thinking, ‘I’m probably not feeling the pain because I’m still medicated.’ So I was trying to reason with myself not to get too excited. But I was thinking, ‘I can feel a little pressure on my back, and if I can feel that, I should be able to feel the pain in my foot.’ And then it just dawned on me: ‘Oh, my gosh, I am OK.’”

An exploration of the molecular links between insulin resistance and inflammation may have revealed a novel target for diabetes treatment, say scientists at the John G. Rangos Sr. Research Center, Children’s Hospital of Pittsburgh of UPMC. Their findings were published earlier this month in the online version of Diabetes, one of the journals of the American Diabetes Association.

Signs of low-grade systemic inflammation are not uncommon among people who have the pre-diabetic condition known as metabolic syndrome, as well as in animal models of obesity and type 2, or insulin-resistant, diabetes, said senior author H. Henry Dong, Ph.D., assistant professor, Department of Pediatrics, University of Pittsburgh School of Medicine.

“But it’s not yet clear if there is a cause-and-effect relationship between chronic exposure to low-grade inflammation and the onset of insulin resistance,” he explained. “Other studies have shown that in patients who have inflammation and diabetes, insulin-sensitizing drugs seem to reduce inflammation while anti-inflammatory therapies improve sensitivity to insulin.”

Senator Edward Kennedy’s death comes as a political struggle appears to be chipping away at the Democratic power-broker’s vision for what he called “the cause of my life,” providing affordable healthcare coverage to all Americans.

After decades of laying the groundwork to overhaul the U.S. healthcare system, Kennedy, who died late on Tuesday at age 77, was forced into a limited role in the fight to enact such legislation since being diagnosed in May 2008 with brain cancer.

Yet despite being away from Congress most of the year, Kennedy, one of the most effective lawmakers in U.S. history, managed to help draft a preliminary bill to overhaul the $2.5 trillion U.S. healthcare system.